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August 1983 Volume 1 | Issue 5
Page Nos. 171-211
Online since Friday, September 17, 2010
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Diffuse Fibrosing Alveolitis - An Indian Experience |
p. 171 |
A. A Mahashur, K. M Dave, S. G Kinare, S. R Kamat, V. M Shetye, V. P Kolhatkar After a planned search between 1969-79, 161 cases of diffuse fibrosing alveolitis were diagnosed. Out of 161 cases, 46% were older than 44 years; only 48 (30%) had a short history of upto one year while 45 (28%) were having symptoms for more than five years. These complained of exertional dyspnoea (grade 3 or less) in 70% and productive cough in 63% cases. Finger clubbing was seen in 53% and cor pulmonale in 26%. Radiologically the disease was unilateral in 11 (8%) and showed an evidence of pulmonary hypertension in 49 (34%) cases. Histological data was available in 63 cases (open lung biopsy in 48 cases and after autopsy in 15 cases). In 29 cases, specific causes were established while in 34 cases, the aetiology was unknown. Pulmonary function tests done in 136 cases, revealed evidence of obstruction in 33 (24%) and a significant (10% or more) response to bronchodilator test was seen in 33% cases. The older subjects tended to have lower pO2 at rest and a lower decline in pO2 after exercise. Those with lower FVC tended to have little expiratory obstruction lower pO2, greater decline in pO2 after exercise and a lower resting oxygen uptake. Of 34 cases followed, only 15 improved after prednisolone. The relapses were associated with lung infections, enhanced hypoxia and CO2 retention. |
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Cumulative Effect Of Salbutamol Inhalation In Perennial Bronchial Asthma |
p. 181 |
P. V Niphadkar, D. D Bohra, A. R Ghamande, V. V Odak Seventy one perennial asthmatics were studied in three groups to determine the therapeutic utility of salbutamol inhaler. when used as a single dose and when used as multiple small dosage regime. First group of 17 patients received single dose of salbutamol (200 mcg), second group of 25 patients received large single dose of salbutamol (800 mcg). PFR, FEVl and FVC were recorded before and after inhalation. Third group of 29 patients received 800 mcg of salbutamol per day in four divided doses for five successive days. In the first group 44% of patients and in the second group 41% of patients showed significant improvement after single dose inhalation. In the third group 68% of severe asthmatics derived significant benefit (PFR improvement more than 60%) within five days. This data suggests that perennial severe asthmatics can derive substantial benefit from cumulative effect of inhalation of salbutamol. Single dose of inhaler was not as useful in treating severe asthmatics as multiplication of single dose at one sitting also does not prove anymore effective. |
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Metronidazole In Suppurative Pleuro-Pulmonary Infection |
p. 185 |
Nigam Pranesh, K. K Kapoor, A. K Gupta, B. M Goyal, S. K Mishra Fifty patients of pleuro-pulmonary suppuration were included in this clinical trial. Majority of them were from fourth decade (39%) of life with male to female ratio of 2.8:1. Metronidazole was administered orally, intravenously and/or intrapleurally with very good results (85.4%). Patients were relieved of their halitosis with remarkable reduction in the quantity of the sputum. Eight patients out of nine in Group II A, who did not respond to antibiotics, responded very well to intravenous metronidazole with a success rate of 88.9%. Good response to metronidazole even in the absence of anaerobic culture gives the clue that infection was most probably due to anaerobic microbes as metronidazole is ineffective on aerobes. It is inferred from this study that patients with copious, purulent sputum with offensive odour, not responding to antibiotics, should be given a trial of metronidazole irrespective of the underlying lung pathology. |
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Effect Of Yoga On Ventilatory Functions In Normal Healthy Volunteers |
p. 189 |
K. J. R Murthy, B. K Sahay, Madhavi Sunitha, Sita Rama Raju, P Ramana Yogi, M Venkata Reddy, N Annapurna, M Ramesh, Vijayalakshmi Prasad, M Eswar Reddy Hundred healthy volunteers (73 males and 27 females) undergoing yoga training certificate course for 90 days were studied. Their ages ranged from 15-55 years. The volunteers included students, office-going executives and housewives. Ventilatory functions were studied on a dry spirometer before and again 15 days and 90 days after undergoing practices. The volunteers were taught PRANAYAMA only for first 15 days and later on yogic practices were added. Parameters studied were FEV1 FVC, FEV1/FVC%, FEF, FMF, FMFT, FET, MVV, and PEFR. Analysis of the results was made by using student's paired 't' test. |
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Diethyl Carbamazine In Allergic Rhinitis |
p. 193 |
Usha Raghavan, Basheer Ahmed, R Balambal, V Kumaraswami, K. V Thiruvengadam Diethyl carbamazine (DEC) essentially an antifilarial drug has been shown to be useful in allergic rhinitis in a double blind study. |
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Thoracic Outlet Vascular Obstruction In Normal Individuals |
p. 195 |
S Muthurajan, Victor Solomon Neurovascular compression in Thoracic Outlet Syndrome (TOS) could occur at various levels. Clinical tests such as Adson's test, Costoclavicular manoeuvre, Hyperabduction manoeuvre and Allen test have been available for clinical evaluation of thoracic outlet syndrome. However, these tests have been found t o be positive even in normal individuals. A study was undertaken to assess the effect of 16 manoeuvres involving inspiration and movements of the shoulder and neck in 50 healthy volunteers. It was found that all these manoeuvres produced a fall in blood pressure. The fall was most marked in abduction of arm. Interestingly the blood pressure was found to increase markedly in the contralateral limb when the ipsilateral limb was abducted, perhaps due to diversion of blood flow. |
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Peak Expiratory Flow Rate As A Reversibility Test In Airways Obstruction Of The Lung |
p. 199 |
S. K Jain, Rajendra Kumar, Dev Ashish Sharma Reversibility test in patients with airways obstructive (A.O.) disease of the lung was done by using isoprenaline aerosol with the help of Wright's peak flow meter. The patients with bronchial asthma showed maximum percentage increase PEFR (after giving isoprenaline) followed by cases of chronic bronchitis, while the patients with emphysema showed least to nil improvement in PEFR. Being a simple and reliable test this can be performed easily to assess the degreo of reversibility in AO patients, and will help in selection of bronchodilators in immediate and long term treatment of the disease. |
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Bronchocoele : Mucoid Impaction Of The Bronchus |
p. 203 |
Rais Nadeem, V. V Jayakar, D. M Kokka, S. B Desai, P. G Kamath A case of ‘ Bronchocoele’ due to mucoid impaction of the ectatic bronchus is reported-The radiological similarity to bronchial neoplasm is drawn attention to. |
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Primary Amoebiasis Of Lung |
p. 207 |
D. V Divekar, C. K Kishore, K Chandramohan Two cases of Amoebic involvement of lower segments of right lung without clinical, radiological and biochemical evidence of hepatic involvement are reported. |
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Recent Advances In Respiratory Medicine - 2 |
p. 211 |
D. C Flenley |
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